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Introduction Transition to a consultant role is a challenging time for an early career psychiatrist, as the high level of structure and guidance available during psychiatric training ceases when training is complete. The Royal College of Psychiatrists, UK therefore pioneered the Startψell initiative to ease this transition. This consultant-led initiative proposed embedding good habits and robust coping mechanisms early on, to enable psychiatrists to thrive in their roles and is based on six main pillars (New consultants (StartWell) (rcpsych.ac.uk) Image 1: Startwell framework. Berkshire Healthcare NHS Foundation Trust (BHFT) is a mental healthcare provider based in Southeast England where we designed a project to enhance support to new consultants, based on Startψwell principles. Objectives The aims of this project were to: - Improve the experience of early career psychiatrists taking on their first consultant role in BHFT. - Ensure that the new consultants are provided with relevant information and resources to fulfil their roles safely. - Set up a system for ongoing support for new consultants till they complete five years in their post. Methods Having discussed the feasibility of setting up a local Startwell initiative in BHFT, plans were presented to the medical director and medical staff committee including new consultants, for their input. Under the guidance from senior consultants, monthly meetings were arranged which offered professional development talks and peer support. As several themes emerged at these meetings, we stratified and aligned these local to the RCPsych Startψell framework (Image 2:Themes). An induction folder was also collated with all the relevant information in paper and digital format. In addition, a yearly bespoke induction event for new consultant psychiatrists was delivered from 2019-2022 except in 2021, during the pandemic. Results We used Likert scales to gather quantitative feedback (Table 1) with free box for comments to capture qualitative feedback (Image 3). Feedback response rate for the three cohorts were 75%, 70% and 80% respectively. 2019 2020 2022 Overall Satisfaction 100% 75% 100% How relevant was the content of the programme to your new role? 70% 100% 100% How far did the programme meet your expectations? 100% 75% 100% Image: Image 2: Image 3: Conclusions The BHFT Startwell initiative has been running successfully for the past five years and been valued by the new consultants. We are therefore continuing to working towards embedding the programme futher and ensuring sustainably for the future. W e are looking to share our experience in the hope that similar programmes are set up and our newer colleagues can enjoy a long, fulfilling, and enjoyable career. Disclosure of Interest None Declared

The DIII-D tokamak has elucidated crucial physics and developed projectable solutions for ITER and fusion power plants in the key areas of core performance, boundary heat and particle transport, and integrated scenario operation, with closing the core-edge integration knowledge gap being the overarching mission. New experimental validation of high-fidelity, multi-channel, non-linear gyrokinetic turbulent transport models for ITER provides strong confidence it will achieve Q ⩾ 10 operation. Experiments identify options for easing H-mode access in hydrogen, and give new insight into the isotopic dependence of transport and confinement. Analysis of 2,1 islands in unoptimized low-torque IBS demonstration discharges suggests their onset time occurs randomly in the constant β phase, most often triggered by non-linear 3-wave coupling, thus identifying an NTM seeding mechanism to avoid. Pure deuterium SPI for disruption mitigation is shown to provide favorable slow cooling, but poor core assimilation, suggesting paths for improved SPI on ITER. At the boundary, measured neutral density and ionization source fluxes are strongly poloidally asymmetric, implying a 2D treatment is needed to model pedestal fuelling. Detailed measurements of pedestal and SOL quantities and impurity charge state radiation in detached divertors has validated edge fluid modelling and new self-consistent ‘pedestal-to-divertor’ integrated modeling that can be used to optimize reactors. New feedback adaptive ELM control minimizes confinement reduction, and RMP ELM suppression with sustained high core performance was obtained for the first time with the outer strike point in a W-coated, compact and unpumped small-angle slot divertor. Advances have been made in integrated operational scenarios for ITER and power plants. Wide pedestal intrinsically ELM-free QH-modes are produced with more reactor-relevant conditions, Low torque IBS with W-equivalent radiators can exhibit predator-prey oscillations in T _e and radiation which need control. High- β _P scenarios with q _min > 2, q _95 –7.9, β _N > 4, β _T –3.3% and H _98y2 > 1.5 are sustained with high density ( $\bar n$ = 7E19 m ^−3 , f _G –1) for 6 τ _E , improving confidence in steady-state tokamak reactors. Diverted NT plasmas achieve high core performance with a non-ELMing edge, offering a possible highly attractive core-edge integration solution for reactors.

In this study, we present an estimate of the gravity signal of the slabs beneath the Alpine mountain belt. Estimates of the gravity effect of the subducting slabs are often omitted or simplified in crustal-scale models. The related signal is calculated here for alternative slab configurations at near-surface height and at a satellite altitude of 225 km. We apply three different modelling approaches in order to estimate the gravity signal from the subducting slab segments: (i) direct conversion of upper mantle seismic velocities to density distribution, which are then forward calculated to obtain the gravity signal; (ii) definition of slab geometries based on seismic crustal thickness and high-resolution upper mantle tomography for two competing slab configurations – the geometries are then forward calculated by assigning a constant density contrast and slab thickness; (iii) accounting for compositional and thermal variations with depth within the predefined slab geometry. Forward calculations predict a gravity signal of up to 40 mGal for the Alpine slab configuration. Significant differences in the gravity anomaly patterns are visible for different slab geometries in the near-surface gravity field. However, different contributing slab segments are not easily separated, especially at satellite altitude. Our results demonstrate that future studies addressing the lithospheric structure of the Alps should have to account for the subducting slabs in order to provide a meaningful representation of the geodynamic complex Alpine area.

We present 294 pulsars found in GeV data from the Large Area Telescope (LAT) on the Fermi Gamma-ray Space Telescope. Another 33 millisecond pulsars (MSPs) discovered in deep radio searches of LAT sources will likely reveal pulsations once phase-connected rotation ephemerides are achieved. A further dozen optical and/or X-ray binary systems colocated with LAT sources also likely harbor gamma-ray MSPs. This catalog thus reports roughly 340 gamma-ray pulsars and candidates, 10% of all known pulsars, compared to ≤11 known before Fermi. Half of the gamma-ray pulsars are young. Of these, the half that are undetected in radio have a broader Galactic latitude distribution than the young radio-loud pulsars. The others are MSPs, with six undetected in radio. Overall, ≥236 are bright enough above 50 MeV to fit the pulse profile, the energy spectrum, or both. For the common two-peaked profiles, the gamma-ray peak closest to the magnetic pole crossing generally has a softer spectrum. The spectral energy distributions tend to narrow as the spindown power $\dot{E}$ decreases to its observed minimum near 10 ^33 erg s ^−1 , approaching the shape for synchrotron radiation from monoenergetic electrons. We calculate gamma-ray luminosities when distances are available. Our all-sky gamma-ray sensitivity map is useful for population syntheses. The electronic catalog version provides gamma-ray pulsar ephemerides, properties, and fit results to guide and be compared with modeling results.

In this study, a South African indigenous microalga Acutodesmus bajacalifornicus was evaluated in different cultivation media. Eleven potential cultivation media were identified and tested on A. bajacalifornicus, a potential source for biodiesel production. A. bajacalifornicus had the highest growth rate in the JG medium (in-house formulation), with a competitive average specific growth rate of 0.47 d−1. The highest biomass productivity was in the Hase medium, but with relatively low productivity of 53.1 mg.L−1.d−1.Analysis of the biomass lipid content and profile of each cell culture, using fatty acid methyl ester (FAME) gas chromatography (GC) showed that the lipid content varied between cultivation media, with minimum lipid content of 20% (w/w) and an average close to 47% (w/w). Utilising biodiesel property predictive formulas, and the lipid profiles obtained in this study, it was possible to predict the properties of biodiesel that could be generated from A. bajacalifornicus. It was found that biomass from eight of the media adhered to South African summer grade biodiesel standards.As such, A. bajacalifornicus is a potential candidate for microalgal biodiesel production in South Africa. However, the bioenergy yield rate would need to be improved to have a similar attractiveness to other studies.

We report a measurement of a beam–target double-polarisation observable (E) for the γ→n→(p)→K+Σ−(p) reaction. The data were obtained impinging the circularly-polarised energy-tagged photon beam of Hall B at Jefferson Lab on a longitudinally-polarised frozen-spin hydrogen deuteride (HD) nuclear target. The E observable for an effective neutron target was determined for centre-of-mass energies 1.70≤W≤2.30 GeV, with reaction products detected over a wide angular acceptance by the CLAS spectrometer. These new double-polarisation data give unique constraints on the strange decays of excited neutron states. Inclusion of the new data within the Bonn-Gatchina theoretical model results in significant changes for the extracted photocouplings of a number of established nucleon resonances. Possible improvements in the PWA description of the experimental data with additional “missing” resonance states, including the N(2120)3/2− resonance, are also quantified.

In patients with longstanding persistent atrial fibrillation (AF), outcomes from catheter ablation remain suboptimal. The convergent procedure combines minimally invasive surgical ablation with subsequent catheter ablation, and may contribute towards maintenance of sinus rhythm in this patient group. We performed the convergent procedure on 43 patients with longstanding persistent AF from 2013–2018. Patients underwent clinical review at 3, 6, and 12 months and thereafter as necessitated by their symptoms. Our dataset describes patients’ baseline characteristics and rhythm control protocols, as well as outcomes including arrhythmia recurrence, the need for antiarrhythmic drugs, requirement for repeat rhythm control procedures, and complications. These data provide a real world insight into the risks and benefits of the convergent procedure in patients with longstanding persistent AF.

BackgroundAlthough there is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts.AimsTo longitudinally examine the extent and persistence of mental health symptoms and the importance of psychosocial and lifestyle factors for student mental health and academic outcomes.MethodUndergraduates at a Canadian university were invited to complete electronic surveys at entry and completion of their first year. The baseline survey measured important distal and proximal risk factors and the follow-up assessed mental health and well-being. Surveys were linked to academic grades. Multivariable models of risk factors and mental health and academic outcomes were fit and adjusted for confounders.ResultsIn 1530 students surveyed at entry to university 28% and 33% screened positive for clinically significant depressive and anxiety symptoms respectively, which increased to 36% and 39% at the completion of first year. Over the academic year, 14% of students reported suicidal thoughts and 1.6% suicide attempts. Moreover, there was persistence and overlap in these mental health outcomes. Modifiable psychosocial and lifestyle factors at entry were associated with positive screens for mental health outcomes at completion of first year, while anxiety and depressive symptoms were associated with lower grades and university well-being.ConclusionsClinically significant mental health symptoms are common and persistent among first-year university students and have a negative impact on academic performance and well-being. A comprehensive mental health strategy that includes a whole university approach to prevention and targeted early-intervention measures and associated research is justified.

Background Paroxysmal gluten‐sensitive dyskinesia (PGSD) in border terriers (BTs) results from an immunologic response directed against transglutaminase (TG)2 and gliadin. Recent evidence suggests that PGSD is only one aspect of a range of possible manifestations of gluten sensitivity in the breed. Hypothesis/Objectives Gluten sensitivity in BTs is a heterogeneous disease process with a diverse clinical spectrum; to characterize the phenotype of PGSD using TG2 and gliadin autoantibodies as diagnostic markers. Animals One hundred twenty‐eight client‐owned BTs with various disorders. Methods Prospective study. BTs with paroxysmal episodes and a normal interictal examination were phenotyped using footage of a representative episode and assigned to 3 groups: idiopathic epilepsy (IE), paroxysmal dyskinesia (PD), or other. Owners of each dog completed a questionnaire to obtain information regarding clinical signs. Healthy BTs formed a control group. Serum antibodies against TG2 and AGA were measured in all dogs. Results One hundred twenty‐eight BTs were enrolled; 45 with PD, 28 with IE, 35 with other conditions, and 20 controls. Three overlapping phenotypes were identified; PD, signs suggestive of gastrointestinal disease, and dermatopathy. AGA‐IgG concentrations were increased in PD, compared with IE (P = 0.012), controls (P

We assess 90 years of change on a Low Wooded Island (Low Isles, Great Barrier Reef), employing drones and topographic profiling to accurately survey ramparts, mangroves, the reef flat and the sand cay. A comparison with maps from the 1928–1929 Great Barrier Reef Expedition revealed the redistribution of an outer rampart and inward movement of shingle ridges. Remarkable lateral expansion of the mangrove woodland some 400 m has occurred as carbonate sand deposition has increased reef flat elevation, obscuring coral microatolls. The sand cay has stayed relatively constant in size, moving approximately 44 m in a northeasterly direction and rotating slightly. We conclude that the existing configuration of landforms probably represents an equilibrium with local biophysical conditions, including sea level, wave dynamics, vegetation growth, storms and cyclones. The variable nature of ramparts and the presence of a trough that prevents the continuous spread of mangroves across a uniformly flat colonization surface precludes the interpretation of landform changes with respect to a geomorphic evolutionary sequence. Moreover, longer-term implications of environmental change for these landforms can only be evaluated once the specific nature of the local carbonate budget, including the relative contribution of corals, foraminifera and Halimeda has been elucidated.